Whether or not to get screened for prostate cancer is a question I get asked a lot since the U.S. Preventive Services Task Force recommended against routine prostate cancer screening.
The main debate surrounds the prostate-specific antigen (PSA) test—a blood test that detects increased activity in the prostate. It has been an important screening blood test, but it can result in false positives. That’s because there are several issues that can directly influence PSA, not just cancer—such as infection, irritation, and benign enlargement. What usually comes next is a biopsy; it’s uncomfortable and carries a small (4 to 7 percent) risk of complications.
That doesn’t mean you can skip prostate screening altogether. In the U.S., around 200,000 men are diagnosed with prostate cancer annually, and about 30,000 die from it. You and your doctor need to determine the surveillance that’s right for you.
If you are a male from 50 to 70 years old, have a history of the disease, or are African-American, you may consider PSA testing. For otherwise healthy men over age 40 who haven’t been diagnosed with cancer, a digital rectal exam may be enough. My fear is that, because of questions surrounding recommendations, men will forgo prostate cancer screening entirely. Newer blood tests, genetic marker tests, and even MRI imaging are being used.
It’s your health, so figure out a plan with your doctor that is responsible but not overly alarmist.
Have a question for Dr. Choi? Email him at AskDrChoi@mensjournal.com.
Benjamin Choi, M.D., is a urologist in New York City and a clinical assistant professor of urology at Weill Cornell Medicine.
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